7-HSS-26-028 - PROMISE Mental Health Group Homes- Attachment 5 - Business References Form.docx

DOCX document 127 KB Posted

Attached to
PROMISE Mental Health Group Homes
Solicitation number
HSS-26-028
Issued by
Delaware

About this file

This document is a Business References Form from the Delaware Health and Social Services Division of Substance Abuse and Mental Health for Contract No. HSS-26-028, titled "PROMISE Mental Health Group Homes". The form requires potential bidders to provide a minimum of three business references, including business name, contact information, years of business association, and type of work performed. The document strictly prohibits listing state employees as references and requires separate documentation for any state contracts held within the past five years.

The form is a standard qualification document for a mental health group homes contract, designed to validate a vendor's professional experience and track record. It provides a structured template for vendors to demonstrate their professional credentials and past performance, which will likely be used as part of the overall evaluation criteria for the contract award. The reference requirements suggest a rigorous vetting process for potential service providers in the mental health group home sector, with an emphasis on verifiable professional experience and established business relationships.

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Delaware Health and Social Services

Division of Substance Abuse and Mental Health d

Delaware Health and Social Services

Division of Substance Abuse and Mental Health d

Attachment 5

Contract No. HSS-26-028 Contract Title: PROMISE Mental Health Group Homes

BUSINESS REFERENCES

List a minimum of three business references, including the following information:

· Business Name and Mailing address

· Contact Name and phone number

· Number of years doing business with

· Type of work performed Please do not list any State Employee as a business reference. If you have held a State contract within the last 5 years, please provide a separate list of the contract(s).

1.
Contact Name & Title:

Business Name:

Address:

Email:

Phone # / Fax #:

Current Vendor (YES or NO):

Years Associated & Type of Work Performed:

2.
Contact Name & Title:

Business Name:

Address:

Email:

Phone # / Fax #:

Current Vendor (YES or NO):

Years Associated & Type of Work Performed:

3.
Contact Name & Title:

Business Name:

Address:

Email:

Phone # / Fax #:

Current Vendor (YES or NO):

Years Associated & Type of Work Performed:

STATE OF DELAWARE PERSONNEL MAY NOT BE USED AS REFERENCES.

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